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Excess Deaths From Pandemic Higher Than Official Numbers

How many people have died in the US so far from the COVID-19 pandemic? It depends on how you count the numbers. The official count of US COVID-19 deaths is 214,000. This number is often reported as “at least” this amount, because this is a compilation of all deaths where COVID-19 was officially listed as a cause of death. Experts recognize that this is likely to be a gross underestimation, because people may die from the disease at home without ever being diagnosed.

In any such system, regardless of how careful you are, there are going to be false positives and false negatives. When it comes to the cause of death there are very specific coding guidelines. COVID-19 must have directly lead to the death of the individual. Laboratory confirmation is strongly encouraged, but doctors may code COVID-19 as a probable cause of, in their clinical judgement, the patient had COVID-19 and it fits the epidemiology, even if they did not get a test. When COVID-19 is severe enough to kill, it is a fairly recognizable clinical condition. This does open the door to other fatal viral respiratory infections to be coded as COVID, but these instances are likely to be rare.

States report their data differently. Some only report confirmed cases. Some report confirmed and probable. Some states get their numbers from death certificates, while others count deaths among diagnosed cases of COVID-19. Taking all of this into consideration, COVID-19 deaths are likely to be underestimated in the aggregate rather than overestimated. Some critics argue that allowing “probable” cases overestimates the total deaths from COVID, but if you look at the data state-by-state you will see that probable cases are small in number compared to confirmed. In Arizona, for example, probable cases are only about 5% of the total deaths reports, the vast majority of which are confirmed. So even in the very unlikely scenario that all probable cases are false positives, that only gives a 5% variance (and keep in mind, many states don’t report probable cases at all).

There is another way to get at the impact of the pandemic other than counting death certificates. Several researchers have looked at excess deaths during the pandemic, either regionally or nationally. The largest such study was just published in JAMA. The total number of deaths in the US is remarkably consistent year-to-year, so a dramatic change in this baseline must have a specific cause. The study found:

Between March 1 and August 1, 2020, 1,336,561 deaths occurred in the US, a 20% increase over expected deaths (1 ,111, 031 [95% CI, 1 110 364 to 1 111 697]).

That’s 225,530 excess deaths. However, only 67% of these excess deaths can be explained as official COVID-19 deaths. If we apply these ratios to the total pandemic, that means that there have been a total of 319,402 excess deaths total during the pandemic (214,000 is 67% of 319,402). This should put an end to any notion that the pandemic is a hoax or overblown or that the total deaths are somehow grossly overestimated. If anything, total COVID-19 deaths are likely underestimated.

Some of these uncounted excess deaths are likely to be missed cases of COVID-19, again most likely from people who died at home. Some are likely due to probable cases that are not reported in those states that only report confirmed cases. But this does not account for all the excess deaths. That data also shows that some of those deaths can be accounted for by increases in the baseline death rate from things like Alzheimer’s disease and heart disease. Such causes can be considered part of the disruption of normal health care. Some people have been delaying care or avoiding emergency departments for fear of catching COVID.

The authors warn that this disruption may cause excess deaths for years, from diabetics not taking care of themselves, disruptions in chemotherapy for cancer patients, and delays in testing such as mammograms. Another category of excess deaths is due to the emotional and economic stress caused by the pandemic, which has lead to an increase in suicides and overdoses.

The study also takes a more granular view of the data, looking state-by-state and showing that the excess deaths coincides with surges of reported cases of COVID-19, as we would expect if COVID was the primary cause.

What, then, is the death toll of the pandemic? Should we count deaths caused by the disruption in health care but not directly related to infection? There is no right or wrong answer here. We can say, neutrally, that the COVID-19 pandemic has directly caused at least 214,000 deaths, although this number is likely an underestimate. Further, it has caused another 100,000 deaths, some of which are likely to be uncounted direct deaths, but the rest are indirect deaths due to the disruptions caused by the pandemic.

Some may wish to focus on the excess deaths due to suicides and overdoses, arguing that these result from our reaction to the pandemic rather than the pandemic itself. This is reasonable, but we need to keep it in perspective. These deaths are a tiny percentage of total deaths. Further, the data also shows that the strongest predictor of deaths is the number of COVID cases. As one of the authors notes:

“We can’t prove causally that the early reopening of those states led to the summer surges. But it seems quite likely,” said Woolf. “And most models predict our country will have more excess deaths if states don’t take more assertive approaches in dealing with community spread. The enforcement of mask mandates and social distancing is really important if we are to avoid these surges and major loss of life.”

Of course we should fight the pandemic smartly and minimize unintended consequences. Mask mandates, for example, not only reduce spread of COVID they allow people to work and get out of the house. Shut downs should be a last resort, but they do work when necessary, and the alternative of letting the pandemic spread has proven the most deadly option.

The post Excess Deaths From Pandemic Higher Than Official Numbers first appeared on NeuroLogica Blog.

10,000 Vintage Recipe Books Are Now Digitized in The Internet Archive’s Cookbook & Home Economics Collection

“Early cookbooks were fit for kings,” writes Henry Notaker at The Atlantic. “The oldest published recipe collections” in the 15th and 16th centuries in Western Europe “emanated from the palaces of monarchs, princes, and grand señores.” Cookbooks were more than recipe collections—they were guides to court etiquette and sumptuous records of luxurious living. In ancient Rome, cookbooks functioned similarly, as the extravagant fourth century Cooking and Dining in Imperial Rome demonstrates.

Written by Apicus, “Europe’s oldest [cookbook] and Rome’s only one in existence today”—as its first English translator described it—offers “a better way of knowing old Rome and antique private life.” It also offers keen insight into the development of heavily flavored dishes before the age of refrigeration. Apicus recommends that “cooks who needed to prepare birds with a ‘goatish smell’ should bathe them in a mixture of pepper, lovage, thyme, dry mint, sage, dates, honey, vinegar, broth, oil and mustard,” Melanie Radzicki McManus notes at How Stuff Works.

Early cookbooks communicated in “a folksy, imprecise manner until the Industrial Revolution of the 1800s,” when standard (or metric) measurement became de rigueur. The first cookbook by an American, Amelia Simmons’ 1796 American Cookery, placed British fine dining and lavish “Queen’s Cake” next to “johnny cake, federal pan cake, buckwheat cake, and Indian slapjack,” Keith Stavely and Kathleen Fitzgerald writes at Smithsonian, all recipes symbolizing “the plain, but well-run and bountiful American home.” With this book, “a dialogue on how to balance the sumptuous with the simple in American life had begun.”

Cookbooks are windows into history—markers of class and caste, documents of daily life, and snapshots of regional and cultural identity at particular moments in time. In 1950, the first cookbook written by a fictional lifestyle celebrity, Betty Crocker, debuted. It became “a national best-seller,” McManus writes. “It even sold more copies that year than the Bible.” The image of the perfect Stepford housewife may have been bigger than Jesus in the 50s, but Crocker’s career was decades in the making. She debuted in 1921, the year of publication for another, more humble recipe book: the Pilgrim Evangelical Lutheran Church Ladies’ Aid Society of Chicago’s Pilgrim Cook Book.

As Ayun Halliday noted in an earlier post, this charming collection features recipes for “Blitz Torte, Cough Syrup, and Sauerkraut Candy,” and it’s only one of thousands of such examples at the Internet Archive’s Cookbook and Home Economics Collection, drawn from digitized special collections at UCLA, Berkeley, and the Prelinger Library. When we last checked in, the collection featured 3,000 cookbooks. It has grown since 2016 to a library of 10,600 vintage examples of homespun Americana, fine dining, and mass marketing.

Laugh at gag-inducing recipes of old; cringe at the pious advice given to women ostensibly anxious to please their husbands; and marvel at how various international and regional cuisines have been represented to unsuspecting American home cooks. (It’s hard to say whether the cover or the contents of a Chinese Cook Book in Plain English from 1917 seem more offensive.) Cookbooks of recipes from the American South are popular, as are covers featuring stereotypical “mammy” characters. A more respectful international example, 1952’s Luchow’s German Cookbook gives us “the story and the favorite dishes of America’s most famous German restaurant.”

There are guides to mushrooms and “commoner fungi, with special emphasis on the edible varieties”; collections of “things mother used to make” and, most practically, a cookbook for leftovers. And there is every other sort of cookbook and home ec. manual you could imagine. The archive is stuffed with helpful hints, rare ingredients, unexpected regional cookeries, and millions of minute details about the habits of their first hungry readers.

Related Content:

The New York Times Makes 17,000 Tasty Recipes Available Online: Japanese, Italian, Thai & Much More

Archive of Handwritten Recipes (1600 – 1960) Will Teach You How to Stew a Calf’s Head and More

A Database of 5,000 Historical Cookbooks–Covering 1,000 Years of Food History–Is Now Online

Josh Jones is a writer and musician based in Durham, NC. Follow him at @jdmagness

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Vietnamese activist and journalist Pham Doan Trang arrested for ‘anti-state propaganda’

‘Send me my guitar and try to have the wardens accept it’

A 2018 video interview with Pham Doan Trang. Source: Screenshot of YouTube video by Člověk v tísni

Prominent Vietnamese activist and journalist Pham Doan Trang was arrested by the police on October 6 for charges related to “conducting propaganda against the Socialist Republic of Vietnam” under Article 88 of the 1999 Penal Code, and “making, storing, spreading information, materials, items for the purpose of opposing the State of the Socialist Republic of Vietnam” under Article 117 of the 2015 Penal Code. She faces up to 20 years in jail if convicted.

Doan Trang is part of the editorial board of The Vietnamese Magazine. She founded the online legal magazine Luat Khoa. She was also one of the founders of the Liberal Publishing House whose books on democracy have been confiscated by authorities. She also co-founded the Vietnam Legal Initiative, a United States-based NGO working to promote human rights in Vietnam.

Doan Trang authored the following books: Politics for the Common People, A Handbook for Families of Prisoners, On Non-Violent Resistance Techniques, Politics of a Police State and Citizen Journalism.

Doan Trang was previously arrested by the police for her role in protests against China’s incursion into Vietnam’s maritime territories and a community action protesting environment pollution. In several interviews, she narrated the attacks and harassment she endured in the hands of the police.

Pham Doan Trang, the night she was arrested. (October 6, 2020) pic.twitter.com/4sCqNnH6fi

— Will Nguyen (阮英惟) (@will_nguyen_) October 9, 2020

It is not clearly stated what prompted her arrest. It could be related to articles she wrote about the government crackdown on land rights defenders or her work with the Liberal Publishing House. Another reason could be linked to security preparations for the plenum of the Communist Party this month since previous meetings were accompanied by similar arrests targeting dissidents and independent writers.

“Just In Case I Am Imprisoned”

Doan Trang, who faced constant threats and surveillance from the police, anticipated her arrest as early as May 2019. She instructed her friend to release a letter titled “Just In Case I Am Imprisoned” if ever she was arrested.

Pham Doan Trang left this letter with me, to publicize upon her arrest. Please share. pic.twitter.com/lVt52Kpkea

— Will Nguyen (阮英惟) (@will_nguyen_) October 7, 2020

In her letter, she asked those who will campaign for her freedom to prioritize other prisoners of conscience. She also wrote about the need to campaign for democratic reforms in Vietnam:

I don’t need freedom just for myself, that would be too easy. I want something much greater: freedom and democracy for all of Vietnam. It might see like some grand goal, but it’s totally possible, with your support.

She added that she will not “admit guilt, confess, or beg for leniency” because she is innocent. She has a personal appeal:

Send me my guitar and try to have the wardens accept it – For me, the guitar is like my Bible.

Several human rights advocates and media groups have issued statements in support of Doan Trang. Tran Quynh Vi, editor-in-chief of The Vietnamese Magazine, wrote about the importance of Doan Trang’s work as a journalist and activist:

Pham Doan Trang is a highly-respected journalist who has diligently expanded the political and legal information for the masses in Vietnam, encouraging people to practice the universal values of freedom and democracy that are stated clearly in Vietnam’s Constitution and which the government has also supported in many of the international treaties it has signed.

Hugo Setzer, president of the International Publishers Association, praised Doan Trang’s efforts to publish books on democratic reforms:

Pham Doan Trang took these risks knowingly in defence of freedom of expression. I salute her bravery and her strength of conviction. We hear her call for election reform in Vietnam, but we must also denounce her arrest and urge the Vietnamese authorities to release her.

As of this writing, Doan Trang’s family was already able to send some items for her personal needs but they have yet to see and talk to her in person.

Written by Mong Palatino


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Azerbaijan and Armenia reach a ceasefire agreement after 10-hour negotiations in Moscow

Russia, the peacekeeper – Trump too busy tweeting about non-issues to help.

Russian Foreign Minister Sergey Lavrov announced before dawn on October 10 that Armenia and Azerbaijan have reached a ceasefire agreement to halt the fighting over the breakaway Nagorno-Karabakh Republic that reignited on September 27. Both Baku and Yerevan sent their top diplomats to Moscow on Friday, October 9, for negotiations under Russian mediation. Foreign Minister Lavrov told the news agency RIA Novosti that the ceasefire talks lasted 10 hours.

Rights groups in Tunisia mobilize against a bill to legalize impunity for security forces

Tunisia – sadly – in retrograde.

As activists mobilized against the bill, police targeted them

A police officer kicks a protester during a demonstration against the police protection bill on October 6. Image credit: Nawaat, used with permission.

As the Tunisian parliament considers a controversial police protection bill, protests erupted in the city of Bardo to oppose it. On October 6 and 8, human rights groups and a youth-led citizen movement dubbed Hasebhom (translated as “hold them to account”) rallied outside the parliament building against the bill, which, if adopted, would legalize impunity for security forces by granting them immunity from prosecution for their use of unnecessary lethal force. 

The Tunisia parliament’s decision to hold a plenary session to discuss the bill —weeks before the 10th anniversary of the revolution that toppled the Ben Ali dictatorship— was met with criticism from human rights groups and activists who have been opposing the bill since it was first submitted to the parliament in 2015. 

As activists mobilized against the bill, police targeted them on- and offline. These attacks on freedom of demonstration and speech are alarming and confirm the concerns of human rights organizations that serious rights violations and persisting gaps in legal protections of rights threaten Tunisia’s strides in protecting human rights since the revolution of 2011.

In the meantime, the parliament announced on October 8 that it will delay discussion on the bill, while activists remain determined to have it completely withdrawn. 

A ‘threat’ to rights and freedoms 

The latest version of the draft law No.25/2015 on the Prosecution of Abuses Against the Armed Forces presents a number of improvements compared to the initial version, submitted to parliament on April 13, 2015. For example, this earlier version envisaged criminal penalties against speech deemed “denigrating” toward the police.

Yet, changes introduced to this recent version have not appeased the concerns of human rights organizations.

On October 6, more than 20 civil society organizations signed a joint statement and launched a campaign dubbed “An Alarming Parliamentary Return,” urging the parliament to reject the police protection bill, along with other bills raising rights concerns, including a state of emergency draft law and draft amendments to the decree regulating broadcast media. According to the statement, the police protection bill “continues to pose a threat to the rights and freedoms of all citizens, despite the amendments that have been included.” 

The proposed law violates Article 21 of the Tunisian constitution of 2014, which states that “all citizens are equal before the law without any discrimination.” Article 7 of the proposed law, which grants security forces immunity from prosecution for the use of excessive and lethal force against citizens in situations deemed “dangerous,” is contrary to Tunisia’s international human rights commitments — particularly with regard to respect of the right to life and the fight against impunity.

In a statement by Amnesty International, deputy regional director for the Middle East and North Africa, Emna Guellali said:

Time and time again, Tunisian and international civil society organizations have fought against this bill, warning of the detrimental impact it would have on the rule of law. If adopted, this draft law would reinforce the culture of impunity and send an alarming message to the security forces that they have the green light to use force as they see fit without worrying about being held accountable.

Security forces unions cite the rising threat of terrorism in post-revolutionary Tunisia to pressure parliament to adopt the bill. Yet, there are numerous laws and decrees that regulate or protect security work and severely punish criminal acts that target security forces.

Protesters and activists targeted 

During the October 6 protest, demonstrators raised signs and slogans against police brutality and impunity, while members of LGBT groups, Damj and Outcasts, were present to denounce police violence against LGBTQI+ individuals.

Footage and testimonies shared by citizen journalists and independent citizen media Nawaat showed police physically assaulting protesters. Four were detained in the Bardo police station for three hours and were denied access to lawyers — a blatant violation of their rights under Tunisia law. Some deputies who joined the demonstrators were also assaulted, including Yassine Ayari, who talked about the assault to a local radio program.

Global Voices spoke with one of the detained activists, Asrar Ben Jouira, a Hasebhom campaign coordinator and member of the Tunisian Human Rights League. Jouira said that she herself was subjected to and also witnessed verbal and physical assaults by police — both uniformed and undercover. She said that a police officer sexually harassed by touching her breasts and also harassed other female demonstrators, by touching their buttocks and verbally abusing them. She also reported that police officers used their personal mobile phones to film her and the other demonstrators, despite the presence of the technical police that used professional cameras.

When she heard that two activists were detained, she went to Bardo police station to check on them and to make sure they had lawyers. She was lured inside the police station by an officer who led her to believe she could check on the activists, but quickly closed the door and informed her that she would also be detained for “rioting,” explaining that her face had been spotted in a video filmed during the protest.

Another police officer showed her on his phone a post on the Hasebhom Facebook page that translates the draft law from legalese standard Arabic to the Tunisian dialect, telling her: “We know you wrote this.”

Asrar and the other detainees were only released after the intervention of a number of deputies. 

Activists targeted for their online views

In a Facebook live stream organized on October 6, Al Bawsala and other civil society organizations to denounce draft laws that threaten human rights, Yosra Frawes of the Tunisian Association of Democratic Women (ATFD) denounced police unions for their “illegal practices” such as “organizing coordinated harassment campaigns on social media against citizens and discriminatory speech based on gender identity.” 

On October 7, Activist Myriam Bribri received a summons from police based on her social media posts critical of the draft law. A public prosecutor later charged her with “insulting others through social media.” She remains free as she awaits trial on December 14. Bribri was also subjected to attacks on social media. In a statement supporting the activist, the Tunisian Forum for Economic and Social Rights (FTDES) said:

This summons comes after she was systematically harassed whether through her page on social media or threatening phone calls coming from personal and administrative phone numbers of police union members.

The abuse of power by police and security forces remains undoubtedly a serious problem in Tunisia, particular as it remains under a continuous state of emergency since November 2015, a period marked by criminal prosecutions for peaceful speech online and offline, attacks against journalists, arbitrary arrests by the police, and numerous cases of police brutality and torture.

As Hasebhom organized the second round of protests on October 8, the parliament ended its plenary session without discussing the bill, postponing its adoption to an undetermined date as was the case in 2017.

Activists celebrated this small win but are not taking a break from their persistent fight until the bill is withdrawn or rejected. While civil society continues the fight against the police protection bill, Tunisian authorities must respect the right to peaceful protest and avoid arbitrary detention even under this everlasting state of emergency.

Written by Rima Sghaier